Use this section to discuss your experiences with prescription drugs, iron injections, and other medical interventions that involve the introduction of a drug or medicine into the body. Discuss side effects, successes, failures, published research, information about drug trials, and information about new medications being developed.

Important: Posts and information in this section are based on personal experiences and recommendations; they should not be considered a substitute for the advice of a healthcare provider.

I've been Gabapentin 30 minutes before bed, just like Steve, even tho my doctor said to take it 1 hour before. I find it makes me sleepy and like Steve, if I push through it, then I can't sleep. I also figured that it would make it last longer over night. I've had success with the Gabapentin for the last week. Wonder why my doctor was so reluctant to prescribe it. BTW I also take Zolpidem for insomnia and the two together work very well for me.

I take 200mg Gabapentin (30 mins before bed), and am thinking of asking my neurologist for a small trial of Horizant to see how they compare. Does anyone have experience with both of these medications...Is there anything I should be aware of? I'm wondering what the sleep duration is for Gabapentin versus Horizant? Are the doses equal to each other?

yawny, the primary difference is that Horizant is more readily and reliably adsorbed by the body. Once in the bloodstream, Horizant is converted to gabapentin. As for doses, Horizant is generally a little be lower dose since it is more completely adsorbed.

My doctor had me try Horizant (600mg vs my normal 900mg gabapentin). The two did exactly the same thing for me. My doctor was very disappointed because he worked on the clinical trial for Horizant. I wasn't because Horizant was going to cost me $300/month and gabapentin is less than $10.

With that said, it is certainly worth a try. It appears that I don't have a problem absorbing gabapentin, but others do. If you are one of them, it is a way to get more gabapentin into the blood stream where you need it to be (and less flowing out of the intestines where it does no good).

Gabapentin duration of action is considered to be 6-8hrs. Horizant is 12 hours. However that doesn't really tell us how long they work for supressing the urge to move for RLS, and almost certainly the effectiveness at helping sleep is different than how long it suppresses the urge to move. Additionally, it is near certain that epigenetic and genetic factors can make an individual person have much longer or shorter duration of effectiveness than the averages listed in the studies cited by the manufacturer. Also the gut microbiome (the total of all the different bacteria in the intestine) seems to have a marked effect on the absorption of gabapentin.

Rustsmith wrote:As you might have noticed from my into on the right of these columns, I live in CO. I am about 100 miles south of Denver and 500 ft lower. We moved here about a year ago partially so that my wife and I would both have access to medical marijuana. I honestly cannot say whether the elevation change from sea level made my RLS worse. I was so badly augmented when we moved and then completely modified my treatment once here that I don't have a basis for comparison. But the current research does tend to indicate that there is a hypoxia component to the disease, which means that until you probably would notice more problems until you adjust to the altitude. Low ferritin levels could also aggravate that since a part of adjusting to the altitude involves an increase in red blood cells. Also, be aware that Denver is a LOT dryer than FL. That might have been the issue with your vision.

When you come to CO and go to one of the retail marijuana shops, what you need to look for will be one of the edible products. These range from gummy bear type candies to cookies and chocolates. Several of us on the board find that the THC products help us more with sleep while the CBD products help with anxiety. Neither seems to help with needing to move. The warning that you will probably hear at the shop for THC is to go easy with it since THC is the intoxicating part of marijuana. For me, a single 5mg candy helps me sleep and usually doesn't leave me with a stoned feeling before my first coffee. Also, candies take about 2 hrs to kick in where smoking or using one of the tinctures will result in faster effects. But the effects wear off faster with smoking and tinctures. Since I want the THC to help my sleep in the early morning hours after the gabapentin wears off, the delayed effects are just what I need.

You sent this to me in January. I'm going to Denver & Winter Park next week and will see how I do. My doctor swears there's no issue w elevation so the only other thing I can think of is the time change. I'll try taking the Horizant at 3pm (5pm EST). I'm nervous about it. I'll let you know what I find. Will also try some marijuana for sleeping if I find a store. Thanks for the help....Laura

My doctor swears there's no issue w elevation so the only other thing I can think of is the time change. I'll try taking the Horizant at 3pm (5pm EST). I'm nervous about it. I'll let you know what I find. Will also try some marijuana for sleeping if I find a store.

The correlation between elevation and RLS symptoms is not well defined as yet. At this point, it is more a statistical correlation than anything else. So, maybe there is something to it, maybe not. But it probably isn't a major issue, like taking Benedryl.

As for the marijuana, you should not have any problems finding a recreational store. The clerks are usually very helpful and can show you the options. All business at the stores is cash, so be prepared. There are also limits about where you can smoke it, so you might want to think about starting out with edibles, like candy or cookies. If so, remember that it takes an hour or so to kick in, so don't over do it the first time around.

Steve, Thanks for your advice on buying marijuana and taking cash. I'm back from my trip. I had a terrible time adjusting to the time change (2 hours) and/or the elevation. Took me 6 days to feel normal. I tried marijuana and found it did help me sleep but did not help w my RLS or switch my body clock. I got this feeling like my legs were so heavy that I could hardly lift them (and I'm thin) and I was incredibly fatigued all day. I finally tried some Kratom and that really helped me adjust. I don't know what it is about it but it seemed to turned things around. I maybe should have tried some other types of mar. but wasn't able to get back to the store. I doubled up on my Horizant and at least prevented PLMs at night. I called the drug company to ask about dosing during a time change and they had no suggestions. Laura

Laura, before I retired I did a not of international travel with time changes as much as 12 hrs. I asked my doctor at one point how to adjust and she just shrugged her shoulders and said that she had no idea. So, I usually ended up either taking an extra dose en-route or skipping one. Once I arrived I would just take my meds on schedule for the local time zone.

These days, when domestically, I just go with the local time zone. When I travel internationally, I take my bedtime meds on an evening flight just before I want to go to sleep and will take an extra half dose of my methadone as needed during the "daytime".

Steve, That's helpful. I'm very hesitant to travel international bc of having problems. Last year when I went to Denver for 3 nights I had big problems w PLM each night - and I'd switched taking my meds on Denver time. This time I did more what you suggest and at least didn't have the night problems. It's surprising no one studies this. Do you mind me asking how severe your RLS is and do you have PLMs? What lead to you taking methadone? My dr gave me levadopa for the plane or for sitting for long periods. It's quicker acting. But it didn't help me enough last week. I would prefer taking a prescription drug than Kratom last week. I have been hesitant to tell my doctor I take it. Have you had that conversation w yours?

My RLS problems went from moderate to severe when I retired. And yes, I also have PLMS.

I am on methadone because I augmented on pramipexole and then Neupro. I was already taking gabapentin as migraine prevention. My doctor had me try Horizant, but it didn't do anything different from the gabapentin. So, that only left the opioids. Currently my medication consists of methadone to control the movement issues, gabapentin works for both my migraine prevention and helps me fall asleep and I also take pramipexole at bedtime to control my PLMS. And finally, about half the time I supplement all that with a THC edible that helps me stay asleep longer because the gabapentin sleep effects wear off after about 4 hrs.

As for conversations with my doctor, she knows about everything that I take. We have had some very involved conversations about my various medications and she has been very supportive. However, with that said, I have to travel 100 miles to Denver in order to see her because no doctor in southern Colorado will prescribe any form of opioid for any chronic illness other than cancer. Dealing with the medical community in Colorado is interesting. Added to the list of questions that a nurse always asks at the start of an appointment is "Do you use recreational drugs?". My reply is that I use marijuana just for medical purposes. The reaction is almost always just a okay, "check that box", just as if I had said that I drink alcohol or smoke (which I do not).

Sounds like it was quite a search to find your doctor and to sort out your medications. It amazes me when I read the news on all these dr's prescribing opiods, I'm thinking, "Where are they?" The people who need them, can't get them, and the people who abuse them, get all they want.

lhoff12085 wrote:Sounds like it was quite a search to find your doctor and to sort out your medications. It amazes me when I read the news on all these dr's prescribing opiods, I'm thinking, "Where are they?" The people who need them, can't get them, and the people who abuse them, get all they want.

I have had the same thought... I would give a LOT to find one of those "pill mill" doctors, lol.

Supposedly there used to be one in the town that I moved to, at least that is the excuse that everyone gives for not prescribing or dispensing opioids here. But no one has ever been able to tell me the name of this supposed doctor whose license was revoked and I have never been able to find anything in the news archives either. I know that pill mills exist, but I always have a suspicion that they are not as common as the press and the various levels of government lead us to believe.